rwanda international elective nuts and bolts / cheat … international elective nuts and bolts /...
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Rwanda International Elective Nuts and Bolts / Cheat Sheet
May 28, 2015
Jeffrey Forris Beecham Chick, MD, MPH
Nikunj Rashmikant Chauhan, MD
David A. Rosman, MD, MBA
Participation Dates: March 21-April 19, 2015
Most Useful Contacts:
Jeffrey Chick: [email protected] (participant)
Nikunj Chauhan: [email protected] (participant)
David Rosman: [email protected] (onsite Human Resources for Health Program diagnostic radiologist)
Partners Centers for Expertise: [email protected] (travel grant funding)
Brigham Research Institute and Center for Faculty Development and Diversity: [email protected]
(microgrant funding)
Rex Wong: [email protected] (housing)
Rwanda Overview:
General: State in central and east Africa
Geography: Bordered by Uganda, Tanzania, Burundi, and Republic of Congo
Ethnic groups: Hutu, Tutsi, and Twa
Languages: Kinyarwanda, French, and English
Government: Semi-presidential constitutional republic
Economy: Subsistence agriculture
Historic: In 1994, the Hutu majority revolted against the colonial favored Tutsi minority which resulted
in deaths of 1 million in 100 days
Centre Hospitalier Universitaire Kigali Overview:
Worksite for international elective
Located in capital city of Kigali, Rwanda
Largest tertiary referral center in Rwanda
500 beds
2 diagnostic radiologists
1 Human Resources for Health Program diagnostic radiologist
1 computed tomography scanner
2 general radiograph units
2 ultrasound machines
Web-based picture archiving and communication system
Image-guided procedures performed on ad-hoc basis
No conventional angiography
Before Departing:
http://travel.state.gov/content/passports/english/country/rwanda.html (Department of State)
http://www.brighamandwomens.org/Departments_and_Services/medicine/services/travelclinic/default.a
spx (Brigham and Women’s Travel Clinic)
Must have at least six months validity remaining in Passport
One blank page required in Passport for entry stamps
Tourist VISA required and purchased for $30 upon entry
Yellow fever vaccination required upon entry
Typhoid fever vaccination is recommended
Malaria prophylaxis strongly recommended
Currency is Rwandan Franc
o In 2015, exchange rate was ~1USD to 700 Rwandan Francs
Supplies:
Our sources of supplies:
CareFusion:
o http://www.carefusion.com/
o Interventional radiology supplies
Boston Scientific:
o http://www.bostonscientific.com/en-US/home.html
o Interventional radiology supplies
Dr. Sandra Duran-Mendicuti (emergency department):
o General travel supplies
Rose Wach (CSIR and angiography supplies department):
o Interventional radiology supplies
Frantz Pierre (angiography supplies department):
o Interventional radiology supplies
Michael Cotugno (pharmacy):
o General pharmaceutical supplies
If taking supplies, email your airline as they will often provide some additional baggage allowance for
humanitarian purposes
Funding:
Our sources of funding:
Partner’s Healthcare Center of Expertise:
o http://www.partners.org/Graduate-Medical-Education/Centers-Of-Expertise/Global-And-
Humanitarian-Health/Funding-And-Resources/Global-Travel-Grants.aspx
o Twenty $2,000 travel awards annually to eligible Partners residents and fellows
o Applications are due semi-annually
Brigham and Women’s Research Institute and Center for Faculty Development:
o http://www.brighamandwomens.org/research/microgrants/default.aspx
o Funds awarded based on merit up to $1000
o Applications evaluated on a rolling basis
Harry Mellin’s Foundation:
o Departmental grants to be discussed with Drs. Seltzer, Weissman, Mayo-Smith, and Smith
Other potential sources of funding:
Goldberg-Reeder travel grant:
o http://www.acr.org/Membership/Volunteering/International-Outreach/Goldberg-Reeder-Grant
o $1,500 grants each year to qualified radiology and radiation oncology residents and fellows
seeking to spend at least one month assisting health care in a developing country
o Submitted by no later than June 30 each year
Gold Humanism presidential grant:
o http://humanism-in-medicine.org/programs/program-grants/
o Presidential level grant applications of up to $5,000
o Reviewed on a rolling basis throughout the year
Housing:
Our housing:
Glory apartments:
o http://gloryapartments.com/new/
o Arranged through Rex Wong (Yale University coordinator)
o Daphrose Murekatete (owner)
o 1 and 2 bed apartments with private bathroom and kitchen
o Need to purchase television and internet
o 12 minute walk to Centre Hospitalier Universitaire Kigali
o 10 minute walk to multiple restaurants and grocery stores
Kigali, as of 2015, was safe to walk around at nearly all hours of the day
Other potential housing:
King Faisal guest house:
o http://www.kfshrc.edu.sa/wps/portal
o 10 minute taxi ride to Centre Hospitalier Universitaire Kigali
Many Human Resources for Health staff in area with extra rooms
Food and Drink:
Grocery stores:
o UTC building
o T2000 building
Restaurants:
o Mexican: Meze Fresh
o International: Heaven Restaurant and Inn
o Indian: Khanna Khazana
o African: Republika Lounge
o Italian: Sol e Luna
o Pizza: White Horse Restaurant
o Ethiopian: Lalibela
o French: Chez Robert
o Chinese: Bamboo
o Coffee: Bourbon Café
Water not safe to consume
Bottled water readily available
Recreation:
Kigali, Rwanda:
o Kigali memorial centre and gisozi genocide memorial centre
http://www.genocidearchiverwanda.org.rw/index.php?title=Kigali_Genocide_Memorial
Volcanoes national park and gorilla trekking:
o http://www.volcanoesnationalparkrwanda.com/
o Obtain Gorilla permit beforehand at the cost of $750
o Secure driver and accommodations
o Kirenga (driver and guide)
Can arrange for the gorilla trekking permits
Charges approximately $500 per person additional for driving to the national park and for
accommodations
Akagera national park and wildlife game drives:
o http://www.african-parks.org/Park_2_Akagera+National+Park,+Rwanda.html
o http://www.african-parks.org/Park_2_92_Ruzizi+Tented+Lodge.html
o Secure driver and accommodations
o Kirenga (driver and guide)
Daily Centre Hospitalier Universitaire Kigali Duties:
800AM-500PM daily
Interpret 25-40 CTs per day
Perform interventional procedures as requested
Complete ultrasounds in the pediatric emergency department and adult wards
Perform barium swallows and enemas
Serve as consultant radiologist
Participate in tumor boards
Round on patients
Post-Experience Deliverables:
Partner’s Healthcare Center of Expertise:
o 2 online blog entries
o 1 summary paper
o 1 group presentation
o Receipts
Brigham and Women’s Research Institute and Center for Faculty Development:
o 1 summary paper
o Receipts
Harry Mellin’s Foundation:
o Report back summary presentation at resident and faculty staff meeting
o Receipts
Academic journal submission on experience:
o Journal of interventional radiology
http://www.jvir.org/
o Academic radiology
http://www.journals.elsevier.com/academic-radiology/
Oral surgeon working at the Centre Hospitalier
Universitaire Kigali
Surgical team performing surgery the Centre
Hospitalier Universitaire Kigali
Physician interpreting radiographic images
with a patient at the Centre Hospitalier
Universitaire Kigali
Computed tomography control room and 64-
slice Siemens Somatom Definition at the
Centre Hospitalier Universitaire Kigali
Maternity ward at the Centre
Hospitalier Universitaire Kigali
Radiology Department at the
Centre Hospitalier Universitaire
Kigali
Web-based picture archiving and
communication system which has
been in place since 2013 at the
Centre Hospitalier Universitaire
Kigali
The need for Interventional
Radiology and image-guided
biopsies in resource-limited
nations such as Rwanda
The need for Interventional Radiology
and image-guided aspirations and
catheter drainages in resource-limited
nations such as Rwanda Donated supplies that was transported
to Rwanda
Donated supplies that was transported
to Rwanda
Jeffrey F. B. Chick performing an
ultrasound-guided catheter drainage on
a 2-year-old female with elevated
amylase and lipase and cystic mass
arising adjacent to the pancreas thought
to represent a pseudocyst
Nikunj R. Chauhan performing a
computed tomography-guided biopsy
on an 11-year-old female with large
predominately fat containing abdominal
mass concerning for liposarcoma or
desmoid.
Nikunj R. Chauhan performing an
ultrasound-guided biopsy on a 4-year-
old female with multiloculated cystic
mass arising from the right adnexa
suspicious for ovarian malignancy with
pseudomyxoma peritonei
Jeffrey F. B. Chick performing a
computed tomography-guided biopsy
on a 22-year-old male with abdominal
distention and weight loss for two years
complicated by urinary retention and
bowel obstruction with extensive
abdominal and pelvis lymphadenopathy
concerning for lymphoma
Nikunj R. Chauhan performing an
ultrasound-guided liver biopsy on a 61-
year-old female with obstructive
jaundice and infiltrative hepatic mass
concerning for cholangiocarcinoma
Jeffrey F. B. Chick preparing for a hip
aspiration on a 3-year-old-male with
fever, left hip and thigh collections, left
pleural effusion, and pericardial
effusion concerning for disseminated
staphylococcus aureus infection
Nikunj R. Chauhan dictating studies at
Centre Hospitalier Universitaire Kigali
Glory apartments kitchen
Glory apartments bedroom
Mountain gorillas in Volcanoes
National Park in Rwanda
Mountain gorillas in Volcanoes
National Park in Rwanda
Mountain gorillas in Volcanoes
National Park in Rwanda
Hippopotamus in Akagera
National Park in Rwanda
Lion in Akagera National Park
in Rwanda
Elephant in Akagera National
Park in Rwanda
Lioness in Akagera National
Park in Rwanda